Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05099 | Date 14/05/2019 |
| Token No | SM/19-20/2714 14/05/2019 | Serial | 028 Last Visit: 14/05/2019 |
| Patient Name | Mr. ABDUL KAYUM | Contact No | 7686829852 |
| Address | CHATRA MUSALMAN PRA BYE LANE | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||